Organization
HAROLD AND GRACE UPJOHN COMMUNITY CARE CENTER
Active
Parent organization
HERITAGE COMMUNITY OF KALAMAZOO
Organization subpart
Yes
Provider details
NPI number
Legal business name
HERITAGE COMMUNITY OF KALAMAZOO
Authorized official
MR. DANA WHITE (ADMINISTRATOR)
(269) 381-4290
Entity
Organization
Contact information
Practice address
2400 PORTAGE ST, KALAMAZOO, MI 49001-3728
(269) 381-4290
(269) 343-5474
Mailing address
2400 PORTAGE ST, KALAMAZOO, MI 49001-3728
(269) 381-4290
(269) 343-5474
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
394090
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09557
BC BS OF MI
MI
05
—
2081160
—
MI
Enumeration date
12/05/2005
Last updated
01/18/2012
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